Medicare Coverage for Jardiance: An Inside Look
Jumpin' Jiminy, Let's Talk Jardiance!
Jardiance is a medicine your doc might prescribe for managing heart failure and type 2 diabetes. Most Medicare Part D prescription drug plans cover Jardiance, and part C plans with drug coverage should, too, but keep in mind that coverage varies by plan.
From June 2022 to May 2023, Medicare splurged around $7 billion on Jardiance, with enrollees coughing up an average of $290 in 2022.
Every Medicare drug comes with a formulary, a fancy term for a list of covered medications. To get coverage, you've gotta enroll in a prescription drug plan that's got Jardiance on its formulary list.
How Much Does Jardiance Cost on Medicare?
According to Optum Perks, the out-of-pocket cost for 30 tablets of Jardiance is around $600, depending on the pharmacy. The amount you'll pay depends on your plan and the tier in which the plan covers this drug. You'll also have to pay a monthly premium (that cost varies by plan) and, sometimes, a deductible (which, for Part D, can't be higher than $590 in 2025).
The dedicated Medicare Glossary is below if you're interested in learning more about terms like out-of-pocket cost, premium, deductible, coinsurance, and copayment.
What Tier is Jardiance with Medicare?
Your plan might place Jardiance in a different tier, and the higher the tier, the more you might pay. Fortunately, the Inflation Reduction Act of 2022 allows the Secretary of Health and Human Services to negotiate new prices for Jardiance and nine other drugs, which should make them more affordable for us enrollees.
Is There a Cheaper Substitute for Jardiance?
Most brand-name drugs are pricier than their generic counterparts, but Jardiance doesn't have a generic version. Bummer, huh?
What Other Medications for Diabetes or Heart Disease are Covered?
Jardiance is a member of the SGLT2 inhibitors family. These drugs work wonders in the kidneys to kick out extra sugar through urine, potentially benefiting the heart and kidneys. Check out the glossary for more info about this.
Whether your plan covers Jardiance or any other heart disease or diabetes drug depends on your specific plan. For example, drugs like metformin, nateglinide, acarbose, and glyburide might be in the mix for diabetes treatment.
Need Jardiance for Free?
You can lower your expenses with financial assistance programs like Medicaid, Extra Help, or State Pharmaceutical Assistance Programs (SPAPs).
Is There a More Affordable Option?
As mentioned, generic drugs are usually cheaper, but Jardiance isn't available in a generic form. Bummer, huh?
What's the Medicare Drug List?
Each plan has its own drug list, outlining which medications are covered. If you'd like to explore this further, check out the link in the glossary.
Our Medicare Terms Glossary
- Out-of-pocket cost: This is the portion of the bill you've gotta cover when Medicare doesn't pay the whole amount or doesn't offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the monthly amount you pay for Medicare coverage.
- Deductible: This is an annual outlay you've gotta make before Medicare starts funding your treatments.
- Coinsurance: This is the percentage of treatment costs that you've gotta pay yourself. For Medicare Part B, that's 20%.
- Copayment: This is a fixed dollar amount you've gotta pay for certain treatments. For Medicare, this usually applies to prescription drugs.
[1] Source: Medicare.gov
[2] Source: MedlinePlus
[3] Source: The Inflation Reduction Act of 2022
[4] Source: Medicare.gov
- Jardiance, a medicine for managing heart failure and type 2 diabetes, is often found in the formulary lists of Medicare Part D and Part C plans with drug coverage, but coverage varies by plan.
- The Inflation Reduction Act of 2022 allows the Secretary of Health and Human Services to negotiate new prices for Jardiance and nine other drugs, which could make them more affordable for Medicare enrollees.
- The out-of-pocket cost for 30 tablets of Jardiance can be around $600, depending on the pharmacy and the plan's tier.
- Unlike Jardiance, other medications for diabetes or heart disease, such as metformin and glyburide, might be covered by some Medicare plans.
